There are several reasons why you may be offered or recommended a C-section and that includes your own wish to have one.
Planned C-section
The reasons for planned C-sections are usually discovered later in your pregnancy either by your midwife during a routine appointment, or during an ultrasound scan. Because of this, there is more time to plan how and when you would like to give birth. Here are a few of the reasons for a planned C-section:
- Maternal choice: A maternal choice C-section is as it sounds, for whatever reason you have decided that you would like to give birth by C-Section.
- Breech position: where your baby is coming bum-first or feet-first doesn’t always mean that a C-section is the safest option for you or your baby but for some, your doctor may recommend a C-section.
- Transverse position: where your baby is lying across your pelvis and neither their head, bottom nor feet can come into your pelvis.
- Placenta Praevia: where your baby’s placenta is covering your cervix and there is no way for your baby to be born vaginally safely for your or for them.
- Previous caesarean section: your doctor or midwife will discuss the risks and benefits of both a vaginal birth after caesarean section (VBAC) and a repeat C-section with you and you will be able to make the choice.
- Concerns about your baby: for example, if they have detected specific abnormalities or problems with your baby’s growth.
- Twins, triplets and more: again, this depends on many factors and your doctor or midwife will be able to take you through the risks and benefits of both vaginal birth and C-section depending on your own personal situation.
- Some maternal infections such as HIV, Herpes Simplex Virus, Hepatitis B and C to reduce the risk of mother-to-baby transmission.
Emergency C-section
Emergency C-sections are any that haven’t been planned during pregnancy, however the speed and urgency at which they need to be done differ depending on the situation. Here are a few of the reasons for an emergency C-section.
- Slow Progress where either your cervix doesn’t dilate (or dilates very slowly) or your baby’s head doesn’t descend through your pelvic, and there are concerns that this may cause problems for you or your baby.
- Fetal Distress: where your midwife or doctor will have concerns over how well your baby is coping with labour. This usually becomes apparent over a few hours.
- Placental Abruption: where your baby’s placenta begins to come away from the wall of your uterus before your baby is born, causing fresh bleeding for your vagina and your baby to become distressed. The severity of the abruption and how well your baby is coping, will determine how quickly you need to have your C-section.
- Cord prolapse: your baby’s cord delivers oxygen from mum and if the cord is occluded at all this will affect how much oxygen your baby receives; too little and they will become distressed. The severest cause of compression of their cord is a cord prolapse, where the baby’s cord comes down through the cervix and is compressed between the pelvis and baby’s hard head preventing oxygen from reaching baby. Once a cord prolapse has been confirmed, and providing baby cannot be born vaginally immediately, a C-section will be performed urgently
- Mum becomes very unwell: pre-eclampsia, fever, or sepsis, or another reason for mum to become extremely unwell are other reasons for a C-section.
Where possible, your anaesthetist will prefer to use a spinal anaesthetic, however rarely, your anaesthetist may determine that a general anaesthetic will be in your best interests.
The Birthrights website has more information on how to request a C-section and NICE explains the guidance given to healthcare professionals on caesarean sections.
If you wish to discuss a plan related to your personal circumstances, you can ask your midwife to refer you to the specialist clinician within your hospital.
